Compare Panels (Quest Diagnostics Panels Only)

This lab test panel is good for men and women.

This panel includes:

• Testosterone, Total, LC/MS and Testosterone, Free (Equilibrium Dialysis)
• Luteinizing Hormone (LH)
• Follicle Stimulating Hormone (FSH)

This panel is useful in determining the health of the hypothalamic-pituitary-testicular axis (HPTA) and whether a man has primary or secondary hypogonadism. Only for men and women not currently on testosterone therapy. If you are on TRT, LH and FSH will be zero or very low, so this panel would not be helpful.

Testosterone, LH, FSH: Everything you Need to Know

The examination of FSH, LH, and testosterone is helpful in the treatment of male infertility.

The primary regulators of germ cell development are:

• FSH (follicle-stimulating hormone)
• LH (the luteinizing hormone)
• Testosterone

This panel is helpful in determining primary or secondary hypogonadism disorder. It is also recommended for assessing the health of the hypothalamic-pituitary-testicular axis, also known as HPTA.

Tests will be worth considering only for persons who do not undertake TRT, LH, or FSH therapy at the time.

What is Testosterone?

Testosterone is the most essential male hormone, with a significant role in developing a man's reproductive system. Still, it plays a vital role in many other areas of health, both for men and women.

Testosterone is produced in the testicles and ovaries. Testosterone is also significantly reduced in the adrenal glands (located above the kidneys) in both sexes.

The brain and pituitary gland (a small endocrine gland at the base of the brain that secretes hormones) control testosterone production.

The hypothalamus transmits to the pituitary gland how much hormone to produce, and the pituitary gland sends the message to the testicles or ovaries. Further on, testosterone, like other hormones, enters the bloodstream, reaching other organs.

Why Should You Test Your Testosterone?

For men, testing may be recommended for:

• Clinical suspicion of androgenic deficiency (primary hypogonadism, hypopituitarism, Klinefelter's syndrome, Down syndrome, delayed puberty, sexual impotence, infertility, estrogen treatment, liver cirrhosis)
• Clinical suspicion of androgenic excess: adrenal cortical tumors, early puberty

In women, testing may be recommended for:

• Polycystic ovary syndrome, virilizing ovarian tumors, adrenal cortical tumors, or congenital adrenal hyperplasia can all cause hair growth, not ovulating, not having periods, or virilization.

What is LH?

Together with FSH (follicle-stimulating hormone), LH belongs to the gonadotropic family. The intermittent release of GnRH from the hypothalamus regulates the pulsatile secretion of FSH and LH.

LH and FSH regulate and stimulate the growth and functioning of the gonads (ovaries and testicles). Cells of the anterior pituitary gland are responsible for producing the two hormones. They reach the blood and from there to the gonads.

In the ovaries, LH and FSH stimulate the growth and maturation of follicles, the formation and evolution of the corpus luteum, and the synthesis and secretion of estrogen and progesterone.

In men, LH stimulates the activity of Leydig testicular cells, which is why it is also called the interstitial cell-stimulating hormone.

The highest level of LH occurs in the middle of the menstrual cycle, inducing ovulation and the formation of the corpus luteum (whose main secretion product is progesterone). In Leydig cells in the LH testes, it stimulates testosterone production and controls the normal maturation of sperm.

Why Should You Test Your LH levels?

For men, LH testing may be recommended for:

• Understanding problems in the hypothalamic-pituitary-gonadal axis (mainly to tell the difference between primary testicular failure and testicular stimulation deficiency)
• Ectopic secretion of LH by neoplasm

In women, testing may be recommended for:

• Understanding problems in the hypothalamic-pituitary-gonadal axis is important for telling the difference between primary ovarian failure and ovarian stimulation deficiency.
• Polycystic ovary disease (Stein-Leventhal syndrome)
• Clarification of the causes of amenorrhea
• Congenital diseases with chromosomal aberrations (Turner syndrome)
• Diagnosis and treatment of infertility
• Ectopic secretion of LH by neoplasm
• Menopausal syndrome

What is FSH?

Follicular hormone (FSH) is an essential component of the body's reproductive function, being responsible for the development of ovarian follicles in women and the production of sperm in men.

In women, ovarian follicles produce estrogen and progesterone and help maintain menstrual cycles.

FSH is required for the start of spermatogenesis and the maturation of spermatozoa.

Higher levels of FSH in infertile men are thought to be a reliable sign of germinal epithelium damage. High FSH blood levels have been linked to sperm production issues like azoospermia and severe oligozoospermia.

In men, FSH is a component of the development of the testicular function, contributing to the production of semen. FSH analysis measures the levels of FSH in the blood.

Your doctor may recommend this test to find the underlying cause of the symptoms that affect your reproductive system.

Why Should You Test Your FSH Levels?

In women, FSH testing may be recommended for:

• Assessment of fertility problems
• Evaluation of irregular menstrual cycles
• Diagnosis of pituitary gland disorders or ovarian diseases

In men, FSH testing may be recommended for:

• Assessment of the reduced amount of semen
• Establish a diagnosis of hypogonadism or gonadal insufficiency
• Establishing testicular dysfunction

What is the HPTA?

HPTA stands for hypothalamic-pituitary-testicular axis. It is composed of:

• GnRH 
• FSH
• LH
• Gonadal steroids

The hypothalamic-pituitary-testicular (HPT) axis is primarily responsible for male reproduction, the development, and the maintenance of male sexual traits.

The primary regulator is GnRH, which controls the male reproductive hormonal cascade. Through a closed-loop feedback system, the HPT axis maintains a dynamic equilibrium of serum levels of reproductive hormones.

After making progress in the study of reproduction, it now looks like the main hypothalamus-pituitary-testicular circuit is not separate, but rather part of the endocrine system. The glands work together to keep the body in balance.

The functional disorganization, at any level, of this general circuit will have transitory or definitive implications for the genital sphere of the male and, more precisely, on his fertility.

What is Hypogonadism?

Men can be born with or develop hypogonadism, a condition in which the testicles do not make enough testosterone and sperm because the hypothalamic-pituitary-testicular axis does not work right.

Hypogonadism is classified into two main categories: primary and secondary. There is no universal cause for this. These two types of testosterone deficiency may be either inherited or caused by a particular event in life, like infections or injuries. Sometimes, these disorders may happen together at once.

The hypothalamus, the pituitary gland, and the gonads (also called the hypothalamic-pituitary-gonadal axis [HPGA] or HPTA) work together to control the testosterone levels and reproductive function of the gonads. The three glands communicate through a cascade of hormones and a self-regulating feedback loop that controls the generation of each hormone. The release of GnRH from the hypothalamus regulates the secretion of other hormones (gonadotropins) that influence the testicles by way of the pituitary. GnRH controls the anterior pituitary secretion of two gonadotropin hormones: luteinizing hormone (LH) and follicle-stimulating hormone (FSH). Luteinizing hormone regulates the production and secretion of testosterone through the Leydig cells of the testes, while FSH stimulates the production of sperm.

When someone is diagnosed with low testosterone blood levels, this is known as "hypogonadism.” There are several types of hypogonadism:

• Primary hypogonadism is a hypergonadotropic condition (higher than normal levels of LH and FSH). This occurs when the testicles fail to produce sufficient testosterone levels to suppress the production of LH and FSH. As a result, LH and FSH levels are elevated while testosterone levels are decreased. The pituitary gland tries to increase testosterone to no avail, even after increasing LH and FSH.

• Secondary hypogonadism results from hypothalamic or pituitary dysfunction. It is characterized by disruption of central components of the HPGA, resulting in decreased levels of GnRH, LH, or FSH. In this type of hypogonadism, low levels of LH do not allow for the proper stimulation of testosterone production by the testes.

• Mixed hypogonadism results from a combination of primary and secondary causes. The most common cause of mixed hypogonadism is late-onset hypogonadism, which occurs with aging. This is associated with osteoporosis, decreased lean body mass, reduced cognition, fatigue, and impaired libido and erectile function. Other causes of mixed hypogonadism include alcoholism, diseases (such as uremia, liver failure, AIDS, and sickle cell disease), street drugs and alcohol, and medications like corticosteroid steroids used for inflammatory conditions. It should be noted that high cortisol levels (hypercortisolism), resulting from either the use of anti-inflammatory steroids or physical causes, could lead to hypogonadism.

What Are the  Symptoms of Low Testosterone (Hypogonadism)?

Clinical symptoms depend on the age at which the hormone deficiency sets in androgens.

If hypogonadism develops before puberty, for example, as part of a genetic condition, the man will have:

• Eunuchoid proportions,
• Delayed secondary sexual characters
• High voice

Symptoms are less specific if hypogonadism develops after puberty and is characterized, for example, by:

• Reduced sexual function
• Infertility
• Decreased energy
• Depression
• Mild anemia
• Decreased muscle volume and strength
• Increased adipose tissue and BMI

Order Your Testosterone Tests Now

As hormones are sometimes unpredictable and may affect us more than we can see with the bare eye, it is recommended to have at least once a year. If any of the symptoms above are present, it is recommended to visit a doctor anytime soon. For testosterone, LH, FSH testing, and many others, go to DiscountedLabs.com and take your test in the proximity of your home.

Click for more information about how to choose the best testosterone test for you.

Suggested Reading: Testosterone Replacement Blood Test Targets

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